骶骨骨折与骨盆骨折

目的：探讨骶骨骨折与骨盆骨折的关系及其治疗。方法：对29例骶骨骨折合并骨盆损伤病例作回顾性分析。25例行保守治疗，4例行手术治疗。结果：除1例死于多器官衰竭外，其余28例骨折均愈合，其中有3例为骨盆骨折畸形愈合。随访6个月－21年，28例中有24例神经功能已恢复正常，另5例功能明显改善。结论；骶骨骨折常合并骨盆损伤，对于骨盆骨折尤其是高能量损伤所致骨盆骨折，应注意是否同时存在骶骨骨折。骶骨骨折治疗方案的选择应考虑骨盆的稳定性和神经系统受累程度。对骨盆稳定性受到严重破坏、存在神经系统损害的患者，均应施行积极的治疗以使移位的骨折断端获得复位，并重建骨盆的稳定性。

Sacral Fractures in Pelvic Injured Patients

Objective:To discuss the association of sacral fractures and pelvic injuries,and treatment.Methods:In the current series,29 sacral fractures combined with pelvic injuries were retrospectively reviewed.Twenty five patients were treated conservatively and four underwent surgical management.Results:All patients experienced fracture union but one who dead of multiple organ failures.Three had posttraumatic pelvic deformity.They were followed up for 6 months to 21 years.Twenty four were normal,four improved.Conclusion:Sacral fractures are often combined with fractures of other components of the pelvis.The assessment of the patients with pelvic fractures,especially the high energy fractures,must include evaluation of sacral fractures.The treatment should be based upon pelvic stability and existing nerve injury.The patients with pelvic ring instability and neurological deficits should be treated in order to reduce fracture and to reconstruct pelvic stability.